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Individual

DR. SUSAN M HEFFLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3027 N CIRCLE DR, COLORADO SPRINGS, CO 80909-1179
(719) 776-4646
(719) 776-4640
Mailing address
3027 N CIRCLE DR, COLORADO SPRINGS, CO 80909-1179
(719) 776-4646
(719) 776-4640

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
40967
KY
207Q00000X
Family Medicine Physician
Primary
DR.0059357
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000638818
ANTHEM BC/BS
KY
05
7100005270
KY
05
9000163357
CO
01
C10499
MEDICARE RAILROAD PTAN
KY
01
DR.0059357
CO MEDICAL LICENSE
CO
Enumeration date
01/11/2007
Last updated
10/18/2023
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